高齢者胃癌症例の術後合併症の検討

DOI Web Site 被引用文献3件 参考文献20件
  • 玉川 洋
    横浜市立大学医学部臓器病態外科学 上白根病院外科
  • 高橋 誠
    上白根病院外科
  • 湯川 寛夫
    横浜市立大学医学部臓器病態外科学
  • 利野 靖
    横浜市立大学医学部臓器病態外科学
  • 高梨 吉則
    横浜市立大学医学部臓器病態外科学
  • 山田 六平
    横浜市立大学附属市民総合医療センター消化器病センター
  • 今田 敏夫
    横浜市立大学附属市民総合医療センター消化器病センター

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タイトル別名
  • POSTOPERATIVE COMPLICASIONS IN ELDERLY PATIENTS WITH GASTRIC CANCER

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Being apprehensive that postoperative complications may occur, we surgeons employ more limited surgeries for elderly patients, especially for those aged 80 and over, in not a few cases. In this study we investigated background factors of elderly patients and operative procedures to elucidate the correlations with postoperative complications and to serve making therapeutic guidelines for them.<br> Methods: Fifty-nine patients aged 75 and over who underwent surgery for gastric cancer from January 2000 to December 2004 were enrolled in this study. They were studied on preoperative underlying diseases and preoperative abnormal laboratory data in terms of postoperative complications. In addition 35 out of the 59 patients aged 79 and under (group A) were compared with 24 patients aged 80 and over (group B) for postoperative complications.<br> Results: A significantly higher incidence of postoperative delirium was noted in patients who had some underlying diseases, and a significantly higher incidence of postoperative SSI was seen in those who were in low nutrition status and/or had impaired renal function. Duration of hospital stay and the first day of starting a meal had no significant correlations with complications. There were no significant differences in background factors and postoperative complications between the group A and B.<br> Conclusions: Although elderly patients with gastric cancer aged 75 and over frequently had underlying diseases and abnormal laboratory findings preoperatively, there were no significant correlations between operative factors such as lymph node dissection and operation time and postoperative complica-tions and prolonged hospital stay. In another comparison between patients over 80 and those under 79, no significant differences were noted. Accordingly we consider that the great age might not be a reason to save lymph node dissection or to employ non-curative operation for candidates for curative operation, if the operation is performed following sufficient preoperative evaluation and under sufficient postoperative management.

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